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Random Review Part 3 Flashcards

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1
Q

Observational Studies summary

A

Cross-sectional: Group of people with a disease, lets see if they have a gene present. Can’t establish causality

Case-control (only retrospective): Group of people with COPD. What were the odds they were smokers for each group? Odds ratio

Cohort (pro or retrospective): Group of smokers, what is the risk of getting COPD?

Clinical trials: Is it safe? Does it work? Is it better? Can it stay?”

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2
Q

Select biases/effects

A

Berkson bias - study population selected from hospital

Pygmalion effect - researchers believe in efficacy of treatment which affects the outcome

Hawthorn effect - Participants knowledge of being studied affects outcome

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3
Q

Disease prevention

A 
Primary = preventing
Secondary = screening
Tertiary = treating
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4
Q

Lymph node structure

A 
Follicle = B cell
Medulla = reticular cells + macrophages
Paracortex = T-cells
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5
Q

Spleen structure

A 
Periarteriolar lymphatic sheeth = T cells
Follics = B-cells
Marginal zone (between red and white) = APCs
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6
Q

Cell markers

A

CD16 (binds Fc) or CD56 = NK cells
CD3/CD4/CD25/FOXP3 = Treg
CD14 (recognizes LPS) = macrophages
CD34 = hematopoietic stem cell

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7
Q

Th1 cells activate:

A

Macrophages (IFN-y)

Cytotoxic T-cells (IL-12)

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8
Q

To activate Th1 or Th2 cells:

A

Th1 by IL-12

Th2 by IL-4

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9
Q

Turn down immune response

A

TGF-B, IL-10

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10
Q

Septic shock and cachexia

A

TNF-a

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11
Q

X-linked agammaglobulinemia

A

Manifestations after 6 months due to IgG from mother still in circulation

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12
Q

IL-12 Receptor Deficiency

A

Decreased IFN-y (due to decreased TH1 response). Often presents after BCG vaccine w/disseminated mycobacterial infection. Also fungal infection.

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13
Q

Hyper-IgE syndrome

A

Deficient Th17 cells (STAT3 mutation) –> neutrophils not recruited to sites of infection

FATED: 
Facies (coarse)
Abscesses (staph)
Teeth (retained primary )
IgE
Derm problems (eczema)
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14
Q

SCID causes

A 
IL-2R defective (most common, X-linked)
ADA deficiency (AR)
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15
Q

Chediak Higashi Syndrome

A

Lysosomal trafficking regulator gene. Microtubule dysfunction. Partial albinism. Peripheral neuropathy. Giant granules in granulocytes and platelets.

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16
Q

Immunosupressants

A

Cyclosporine –Binds cyclophilin, blocks calcineurin, no NFAT, no IL-2 transcript
Tacrolimus – Binds FKBP, same as above, no IL-2 transcript
Sirolimus (Rapamycin) – Binds FKBP, inhibits mTOR, prevents IL-2 response
Daclizumab, basiliximab – blocks IL-2R
Glucocorticoids – Inhibits NF-kB

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17
Q

Bcl-2 inhibits:

A

BAX/BAK and Apaf-1

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18
Q

CD11/CD18 (LFA-1/Mac-1)

A

Let’s fuck mac daddy, Im 18 now. Integrins on leukocyte. defective in LAD type I (effects tight binding). ICAM, VCAM (POV, vag cam) to film it. The endothelial sites for tight binding.

If you have decreased Sialyl Lewis to initiate the whole process, thats LAD type 2 (effects margination and rolling)

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19
Q

Wound healing factors

A

PDGF - smooth muscle cell migration, fibroblast growth for collagen synthesis
FGF - Stimulates angiogenesis
EGF - Cell growth via tyrosine kinases
TGF-B - angiogenesis, fibrosis, cell cycle arrest

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20
Q

TNF-a

A

Important in maintaining granulomas

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21
Q

Amyloidosis

A

Cardiac atria - ANP
Thyroid - Calcitonin
Pancreatic islets - Islet amyloid polypetitde (Amylin)
Cerebrum - B-amyloid
Pituitary - Prolactin
Old age - transthyretin (esp in myocardium)

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22
Q

Dermatomyosites malignancy

A

Think GU

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23
Q

c-kit

A

GIST

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24
Q

NF1 vs NF2 gene

A

NF1 = Ras GTPase, neurofibromin

NF2 - Merlin (schwannomin) protein

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25
p16
Melanoma
26
VHL
Inhibits hypoxia inducible factor 1a
27
PO2 of umbilical vein
pretty low, at 30mmHg
28
Fetal flow of blood (IVC vs SVC)
IVC - FO | SVC - PA to ductus
29
Remnants
allaNtois --> mediaN umbilical vein umbiLical arteries --> mediaL umbilical ligaments umbilical vein --> ligamentum teres hepatis inside falciform ligament
30
Most peripheral resistance is from which vessel:
arterioles
31
When graphing cardiac vs vascular function curves
Inotropy changes cardiac function slow Venous tone changes x intercept TPR changes both curves at same time, but maintains same meeting point at the x axis (vasopressors, exercise)
32
Heart sounds summary
Systolic - aortic/pulmonic stenosis, mitral/tricuspid regurg, VSD, MVP Diastolic - aortic/pulmonic regurg, mitral/tricuspid stenosis
33
Holosystolic murmurs (2 of them)
MR/TR vs VSD -- high pitched blowing at apex vs harsh-sounding at LSB
34
Opening snap/S2 length
Less = worse because over time LA develops more force and is able to open it quicker.
35
PDA
congenital rubella
36
U wave
Hypokalemia
37
Drugs that prolong QT
Some risk meds can prolong QT Sotalol, risperidone, macrolides, chloroquine, protease inhibitors, quinidine, thiazides/TCAs Also ondansetron and haldol
38
Congenital long QT
1) Romano-Ward (AD), most common | 2) Jervell and Lange-Nielsen syndrome (AR), +sensorineural deafness [2 names, 2 problems]
39
Rate and rhyhtm control drugs
Rate: B-blockers, digoxin, non-dhp Ca2+ blockers Rhythm: IC or III
40
Nesiritide
recombinant BNP (think, nesa has no brain)
41
Baro/chemoreceptors transmit to:
solitary nucleus of medulla
42
Free wall rupture due to
macrophage mediated structural degradation (days 3-14)
43
All septal leads =
Anterior (LAD)
44
I, aVL, V5-V6
Lateral (LCX)
45
II, III, aVF
Inferior (RCA)
46
Post MI pericarditis
Fibrinous - 1-3 days after | Dressler syndrome - autoimmune, 2+wks after
47
Loffler syndrome
Endomyocardial fibrosis w/eosinophilic infilitrate
48
heart failure cells
pulmonary edema can cause hemosiderin laden macrophages over time
49
endocarditis on heart valve cause
s. epidermidis
50
Cardiac tumors
Mxyoma most often in left atrium | Rhabdomyomas associated with tuberous sclerosis
51
Kaposi vs bacillary angiomatosis
lymphocytic vs neutrophilic infilitrate
52
Polyarteritis nedosa
Associated with HBV Does not involve pulmonary arteries Immune complex mediated Transmural inflammation w/fibrinoid necrosis
53
Microscopic polyangiitis
Like Wegeners but without the nasopharngeal involvement, no granulomas, and instead p-ANCA mediated
54
Churg-Strauss
associated with peripheral neuropathy and wrist/foot drop
55
Nitroprusside caution
Cyanide toxicity, tx w/sodium thiosulfate
56
Fenoldopam
D1 agonist that decreases BP and increases natriuresis
57
Class I drugs
IB is Best post-MI, IC is Contraindicated post-MI (and structural/ischemic disease)
58
Related hormones
Alpha subunit: TSH, FSH, LH, hCG Stim by CRH: ACTH, MSH, B-endorphin Stim by TRH: TSH, prolactin
59
Cortisol effects
- Upregulates a-1 receptors on arterioles to increase sensitivity to norepi and epi - Can find aldo receptors at high levels - Decrease osteoblast activity
60
PTH and VitD
Very similar, including feedback regulation. Only diff is that VitD stims absorption of both Ca and phos
61
Mg and Ca
Decreased Mg increases PTH seceretion, but severely depleted Mg decreases PTH because its needed as a cofactor. Thus patients resistant to Ca correction must first have Mg fixed.`
62
cAMP hormones
FLAT ChAMP | FSH, LH, ACTH, TSH, CRH, ADH (V2), MSH, PTH
63
Thyroid hormone functions
Increase B1 receptors in heart | Increase Na/K-ATPase activity
64
Riedel thyroiditis
Thyroid replaced by fibrous tissue, can mimic anaplastic carcinoma. Related to IgG4 systemic disease (autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis)
65
Increased cAMP in urine
PTH
66
cyclists nerve injury
Ulnar
67
Denosumab
Monoclonal ab against RANK-L
68
Von Gierke
Glycogen storage disease (g6phostase) but can also present with excessive uric acid
69
Reactive arthritis after:
Post-GI (dysentery causers), or post-chlamydia infections
70
Poly/dermatomyositis histology + immuno
``` Polymositis = CD8 endomysial Dermatomyositis = CD4 perimysial ```
71
Lichen planus
6Ps: Pruritic, purple, polygoal, planar, papules | Associated w/HCV
72
-dronates
bisphosphonates. pryophosphate analogs. bind hydroxyapatite, inibiting osteoclast activity
73
Spinda bifida occulta AFP
normal. the other NTD have increased
74
Not protected by BBB
Area postreme, OVLT (osmotic sensing), neurohypohysis
75
Phases of sleep
``` Awake (Eyes open) B Awake (Eyes closed) A N1 T N2 S(sleep spindle/kcomplex) N3 D REM B ```
76
Lateral Medullary Syndrome
Nucleus ambiguous effects (specific to this syndrome) PICA -Don't pick a (PICA) horse (hoarseness) that can't eat (dysphagia)
77
Lateral pontine syndrome
Facial nucleus effects (specific to this syndrome) | -Facial dronyu op means the AICAs pooped
78
Friedreich ataxia
Friedreich is fratastic (frataxin), hes always stumbling around and falling, but he has a big sweet heart. Chromosome 9
79
Cavernous Sinus components
Occular movements + V1, V2 (III, IV, V1, V2, VI) | Postganglionic sympathetic pupillary fibers --> horner syndrome
80
Curtain drawn down vision
retinal detachment
81
Butorphanol
mu partial agonist, kappa agonist --> good for migraie or labor, causes less respiratory depression
82
Tramadol
Extremely weak opiod agonist, also blocks 5HT and NE reuptake [tram it all] Caution: serotonin syndrome
83
Local anesthetics
Amides have 2 I's in the name, esters have 1. Esters more likely to produce allergy. Block inner portion of Na channel
84
Amantadine
Used to be used for influenza A, but now used to increase dopamine release and decrease reuptake for parkinsons.
85
Selegiline
Preferentially blocks MAO-B, which mostly degrades dopamine and not NE or 5HT

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